New-age Fires: Fire Safety in ICUs and NICUs

02 Sep 2026

Tags: Disaster Management   Risk & Preparedness   Disaster response

Source: The Hindu

Context: India’s fire-safety risks have expanded beyond traditional sites such as industrial units, offices, mass gatherings, firecracker units and railway compartments to residential buildings, hotels and hospitals, particularly Intensive Care Units (ICUs).

• Electrical fires have increasingly emerged as a major concern due to greater appliance use, overloaded electrical systems and inadequate maintenance.
• ICUs are particularly vulnerable because of their oxygen-rich environment, dense electrical equipment and difficulty of evacuating critically ill patients.

Recent ICU/NICU Fire Incidents

• Back-to-back fires in neonatal ICUs (NICUs) at Amravati, Maharashtra, and Chhindwara, Madhya Pradesh, resulted in injuries/deaths among highly vulnerable newborns.
• At Amravati, the fire was extinguished within about 30 minutes, but smoke severely affected three babies admitted with complications; a faulty ventilator was suspected.
• At Chhindwara District Hospital, a short circuit in a baby warmer triggered a fire, causing burns to three newborns.
• Similar incidents have continued despite previous tragedies, including the 2024 Jhansi hospital fire, in which 18 newborns died, indicating inadequate institutional learning and enforcement.

Why ICUs/NICUs Are Uniquely Vulnerable

• ICUs are often sealed or enclosed compartments, allowing smoke to accumulate rapidly and making evacuation difficult.
• NICU patients, particularly newborns, cannot evacuate themselves, making dependence on trained hospital staff extremely high.
• Oxygen-rich surroundings can intensify combustion, while the large number of electrical and electronic devices increases the potential for electrical faults.
• Therefore, ICU fires require a distinct fire-safety and evacuation framework, rather than being treated like ordinary building fires.

Essential ICU/NICU Safety Measures

• A well-designed ICU should ideally have three independent exits, with at least two enabling horizontal evacuation to a safer compartment on the same floor.
• Critical safety infrastructure should include automatic sprinklers, independent power lines for major equipment, secure oxygen-cylinder bed supports and periodic fire drills.
• Oxygen outlets should be positioned away from electrical sockets to reduce the risk of ignition.
• In NICUs, where patients cannot self-evacuate, regular evacuation drills and clearly defined staff responsibilities are particularly important.

Recommended Institutional Measures

• Following a Delhi NICU fire, the National Neonatology Forum (NNF) called for:
  • Mandatory fire-safety certification for hospitals with NICUs.
  • Regular electrical/power audits.
  • Analogue addressable fire alarms for more precise identification of the location of a fire.
  • A standardised evacuation protocol based on RACE — Rescue, Alarm, Confine, Extinguish/Evacuate.
• The 2026 National Guidelines on Fire and Life Safety in Healthcare Facilities provide an important framework for improving fire and life safety in healthcare institutions.

Emerging Risk: Electrical Harmonics

• Electrical harmonics are distortions in the normal sinusoidal electrical current produced by equipment containing electronic components.
• NICUs contain numerous electronic devices that can generate such distorted currents, potentially causing silent overheating of neutral wiring, transformers and loose connections without necessarily triggering conventional circuit breakers.
• Consequently, post-fire investigations that simply attribute incidents to a “short circuit” or “technical fault” may overlook underlying harmonic-related electrical degradation.
• Regular power-quality and harmonic audits should therefore complement conventional electrical safety inspections.

Way Forward

• Treat ICU/NICU fires as a distinct disaster-safety category requiring specialised infrastructure, evacuation protocols and trained personnel.
• Strengthen enforcement of healthcare fire-safety standards through mandatory certification, periodic electrical audits and evacuation drills.
• Move beyond post-incident explanations such as “short circuit” and investigate power quality, electrical harmonics and equipment maintenance as potential underlying risks.
• Fire safety in hospitals must focus not only on fire suppression but also rapid evacuation of patients who cannot independently escape.